The purpose of this application for a Mentored Clinical Scientist Research Career Development Award (K08) is to allow the applicant sufficient protected time to 1) develop the statistical and methodological skills necessary to perform high quality health services research, 2) develop additional skills in study design and implementation, and 3) further develop leadership and management skills to lead a productive research team. In the long term, Dr. Friedman hopes to: 1) identify areas of sub-optimal care and health care variation using administrative datasets and data from large clinical trials, 2) identify optimal cae improvement strategies within the context of comparative effectiveness research, and 3) perform clinical research to assess the validity and benefit of quality improvement initiatives. Specifically, Dr. Friedman's plan includes a focus on developing an expertise in causal inference methodology, a framework of analysis that will allow him uniquely poised to perform high-impact research in his field. Through formal biostatistical training, active participation in analysis of complex datasets, close mentorship by Dr. Cande Ananth and Dr. Jason Wright, attending lectures, journal clubs, conferences, and symposia, and performing the research analysis evaluating intrapartum care quality outlined in the application, Dr. Friedman hopes to substantially enhance his capabilities as a researcher. Dr. Friedman has identified Dr. Wright and Dr. Ananth because of their expertise in epidemiology, biostatistics, and health outcomes research as well as their long track record of successfully mentoring junior faculty. Dr. Ananth is an internationally renowned perinatal epidemiologist whose research work focuses on developing and applying innovative statistical approaches to studies in human reproduction. Dr. Jason Wright is a gynecologic oncologist, experienced clinical trialist, translational researcher, and epidemiologist. Dr. Wright and Dr. Ananth are both committed to working closely with Dr. Friedman. With increased knowledge of the complexities of biostatistics and research methodology, Dr. Friedman will gain the ability to independently perform high-quality health outcomes research. He has identified a senior advisory panel to oversee his progress and will meet quarterly with this group. The research strategy for this application is a novel population-based care quality study evaluating candidate measures for quality of intrapartum care. To summarize the study, Dr. Friedman notes that little is known about baseline adherence to obstetric practices that may be representative of care quality during labor and childbirth and how physician, provider, and patient factors influence adherence. Given that there is no agreement on how to best measure the quality of obstetric care, valid measures of intrapartum care quality are urgently needed. With his excellent mentorship team, Dr. Friedman's research plan may result in clinically relevant and useful findings that improve maternal care.